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20-102710-Building Permit Application41k CITY OF PERMIT APPLICATION PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325 Federal Way 253-835-2607 + FAX 253-835-2609 + permitcenter(&_cityof ederalway.com PERBuT NumBER _a `vim - 1 C- 2 —11 0— — — TARGET DATE -7-31-,3c C) SITE ADDRESS TYPE OF PERMIT NAME OF PROJECT PROJECT DESCRIPTION Detailed description of work to be included on this permit only PROPERTY OWNER CONTRACTOR APPLICANT PROJECT CONTACT (The individual to receive and respond to all correspondence concerning this application) PROJECT FINANCING When aalue is $5,000 or more (RCW 19.27.0951 SUITE/UNIT i< NO ASSESSOR'S TAX/PARCEL # BUILDING )4 PLUMBING )(MECHANICAL ❑ ]DEMOLITION 0 ENGINEERING ❑ FIRE PREVENTION PRIMARY PHONE ZS 5 35(4 S 5 10 NG ADDRESS E-MAIL 1�ISE U inSfi fi STATEPHONE a +c.e.oa E-MAIL � mI hod C ({��STATE Zq J�l � i LEX 4.0 FAX WA STATE CONTRACTOR'S LICENSE # —NblZi IIRATION DATE i 4AI # cz- PRIMARY PHONE, - S-3iQ� MAILLIN ADDRESS 4 EMAIL ,(--Cd ff t�STATE [j " f ZIP p� .1 1)- % FAX l )I%� 1 'TbU&-� PRIMARY PHONE JfUG 5u� MAILING ADDRESS E-MAIL ., oil rl,-, t-#i lee (�, 1 J1�t�M ii✓�TJ 1 172 FAX NAME OWNER-F;NJCED MAILING ADDRESS, CITY, STATE, ZIP CC) I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best Of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws. I further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in the investigation and defense of such claim] which may he made by any person, including the undersigned, and filed against the city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the Wormation supplied to the city as a part of this application. SIGNATURE: PRINT NAME: DATEjy�O�V�� Bulletin # 100 — February 19, 2020 page 1 of 2 k:\HandoutslPermit Application VALUE, OF MECHANICAL WORK MECHANICAL PERMIT $ Indicate how man.y of each type o re to be installed or relocated as part o this ro ect. Do rwt include existi res to remairL AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS (Gmm ...W) -� /i�'�I en s BOILERS �_ FURNACES HOT WATER TANKS (c-) COMPRESSORS GAS SAG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES VALUE OF PLUMBING WORK PLUMBING PERMIT $ Indicate hoof many of each type o re to be installed or relocated as part of this project. Do not include existin res to remain. _ BATHTUBS (or Tub/shoo ,combo} LAVS (Hand Sinks) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Dcscnbr.) ➢RAINS SHOWERS VACUUM BREAKERS _ DRINKING FOUNTAINS SINKS (Kftc h nluwicy) WATER HEATERS (Ele[ui ) � ` HOSE BIBBS SUMPS WASHING MACHINES TOTAL > IXTIIRF.S GENERAL INFORMATION CRITIC/'AL AREAS ON PROPERTY? 1 bl lX IWATER �P�URVEEYIOR� V �L�L ti b�� UiY� SEWER PUR/-V,EYYO�RJ-��j%� �j� ' V` �' VALUE OF FMSTING IMPROVEMENTS EXISTING/PREVIOUS USE Lao - LOT SIZE jIn Sqa a Feet) f 0' -ZS D EXISTING FIRE SPRINKLER SYSTEM? 7 YesA No PROPOSED F111E SUPPRESSION SYSTEM? ❑ Yes x No RESIDENTLA.L - NEW OR ADDITION AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT ............ .................. ........---- FIRST FLOOR (or Mobile Homei SECOND FLOOR 4S -- COVERED ENTRY Ct �J L DECK GARAGE N CARPORT © f ems+ (c e ...._._ ....... ....-.......................... - .... - .......... - .... - ...... OTHER (describe) Area Totals ..mT 0 "I'll— � 79T L ESTIMATED SELLING PRICE $ _ )_, I # (7F BEDROOMS COMMERCIAL - NEW/ADDITION AREA DESCRIPTION .Area in Square Feet Occupancy Group(s) Construction a # of Stories Additional Information NEW Bummm. ADDITION COMMERCIAL - REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area in Square Feet Occupancy Group(S) Construction a # of Stories Additional Information TOTAL BUILDING TENANT AREA ONLY PROJ$cT AREA ONLY Bulletin 9100 — February 19, 2020 Page 2 of 2 kAHandoutslPerinit Application IsllVaga 1e4uaplsa8\s1n0pueH\:1 S iQ T aBed 8T0Z 'T ;sn2ny — 90T# uflaling ueld alis leuoljlppe auo p p (sjuawa,unbar japod aolsabod buimollolaas) japed aald auo p ❑ (swawaimbai jaalaDd Jojsa6Dd bu!mollojaas) sigaed slioM ailgnd oM.L p p (sjuawaltnbal;a)pDd lof sabod buimollof aas) japed Suluueld auo p p (sjuawalmbar jayaod jojsabod burnmollof aas) sjaNaed Sulplln8 omj ❑ ❑ •(plai} uleap ao walsAs oljdas aqj of [slaanjonajs Buljslxa aqj uegljasola si jegj uoljanajsuoo to swoojpaq apnpul jegj suoi1 ppe ao uoljonjjsuoa Mau jol) juawjaeda(] yjleal-I AjunoD Vupl aqj woaj;aped lenoidde agdas aqj jo Ado:) auo p p Ho (Aluo umonjjsuoa mau aol) Ajlllgelleny JaMaS 10 aje31111ia:) auo ❑ (Aluo uoljan�jsuoo Mau aol) Azillgellend JajeM10 ajeayliaD auo ❑ saa,f algealldde aol pae:).aajselN/esln ao `gsea'jaa4D ❑ ❑ jsllpa4:) le1juaplsaa Aliwed @fouls ❑ waoj uoljeallddd Tlwlad Sulplln8 pajaldwoD ❑ qnS baa S1N3Wfl:)oa millW8f1S 1VH3N39 ON f9 saA El :eaae pjezeq pooh lelaads a ur41lM pawaol Avadoid pafgns aqj sl ON LS saA ❑ :uol;alpsunf aullajogs a ulq;lM paieaol Apadoid joafgns aqj sl ON Jl saA p :seaae leol4laa Aljejuawuo.rinua aneq Ajiadoid;aafgns aqj saoa WaweN 13afoad •seaae leoljiaa sulejuoo Ajaadoid 1noA 11 aulwja;ap oj'woo•AemleaapajjoAjla@Buluueld ao 'SS9Z-SE8 -£SZ je uolslnl❑ Ouluueld aqj jaejuoD -asuadxa s,juealldde aLlj le juejlnsuoo s,Ajla aqj Aq MalAGI aaad pue :wodaa seajb leoljpD a jo lejjlwgns ajlnba-i Aew siyl -M@IAal pafoid ul Aelap plane of uoilealldde jlwjad 2ulpllnq Apwej alsuls a suljjlwgns of aolad pajeA jo/pue 'pa}eaullap 'paMalnaJ aq pinogs Ajaadoid jaafgns aqj jo jaal 5Zz ulgl!m jo uo (saa}4nq pajelaosse pue `seaae snopiezey AlleaOoloaS 'sweaajs 'spueljam) seaae lealjua AllejuawuoaiAua lld pa4daaae act jou lllm suoi}ealldde axaldwo:)m :axou aseald -uoljlppe JO aauaplsaa Allwe; 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